目的观察养心活血通脉汤对舒张性心衰患者(心气亏虚、痰瘀阻络证)左室舒张功能及N末端脑利钠肽原(N terminal pro B type natriuretic peptide, NT-proBNP)的影响。方法将65例患者随机分为治疗组33例与对照组32例,两组均以西医常规治疗...目的观察养心活血通脉汤对舒张性心衰患者(心气亏虚、痰瘀阻络证)左室舒张功能及N末端脑利钠肽原(N terminal pro B type natriuretic peptide, NT-proBNP)的影响。方法将65例患者随机分为治疗组33例与对照组32例,两组均以西医常规治疗,治疗组在此基础上加服养心活血通脉汤,治疗1个月后观察两组的临床疗效及治疗前后Lee心衰积分、中医证候积分、全血NT-proBNP、二尖瓣舒张早期血流峰值(EPFV)与二尖瓣舒张晚期血流峰值(APFV)之比值、二尖瓣环舒张早期运动峰速度(Ea)与二尖瓣环舒张晚期运动峰速度(Aa)之比值的变化。结果治疗组治疗后心衰疗效及中医证候疗效均优于对照组(P<0.05);治疗后两组Lee心衰积分和中医证候积分均较治疗前明显减少(P<0.01),且治疗组改善优于对照组(P<0.05);两组患者治疗后EPFV/APFV、Ea/Aa及NT-proBNP均较治疗前明显改善(P<0.01),且治疗组改善优于对照组(P<0.05)。结论养心活血通脉汤可提高舒张性心衰患者的临床疗效,改善左室舒张功能,其作用机制与降低NT-proBNP相关。展开更多
Patients with diastolic heart failure(DHF) have significant abnormalities in left ventricular(LV) diastolic function, including slow and delayed relaxation and increased chamber stiffness. Whether and to what extent t...Patients with diastolic heart failure(DHF) have significant abnormalities in left ventricular(LV) diastolic function, including slow and delayed relaxation and increased chamber stiffness. Whether and to what extent these abnormalities in diastolic function occur in association with abnormalities in LV systolic performance, function, and contractility has not been investigated thoroughly. Methods and Results-The systolic properties of the LV were examined in 75 patients with heart failure and a normal ejection fraction(ie, DHF) and 75 normal control subjects with no evidence of cardiovascular disease. LV systolic properties were assessed with echocardiographic and cardiac catheterization data. Stroke work(an index of LV systolic performance), preload recruitable stroke work and ejection fraction(indices of LV systolic function), systolic stress-shortening relationship, end-systolic pressure-volume relationship, and peak(+ )dP/dt(indices of LV contractility) were examined. The systolic properties of the LV were normal in patients with DHF. Stroke work was 8.4± 2.3 in DHF versus 8.8± 2.5 kg· cm in controls(P=0.26). Preload recruitable stroke work was 99± 22 in DHF versus 109± 18 g/cm2 in controls(P=0.13). The relationship between stroke work and end-diastolic volume was similar in DHF and controls. Peak(+ ) dP/dt was 1596± 362 in DHF versus 1664± 305 mm Hg/s in controls(P=0.54). The end-systolic pressure-volume relationship was increased in DHF. The systolic stress versus endocardial fractional shortening relationship was similar in DHF and controls. Conclusions-Patients with DHF had normal LV systolic performance, function, and contractility. The pathophysiology of DHF does not appear to be related to significant abnormalities in these systolic properties of the LV.展开更多
The prognostic values of tissue Doppler imaging and color M-mode diastolic indexes were studied in 225 patients who had symptomatic systolic heart failure in the ADEPT study. The primary end point of death, transplant...The prognostic values of tissue Doppler imaging and color M-mode diastolic indexes were studied in 225 patients who had symptomatic systolic heart failure in the ADEPT study. The primary end point of death, transplantation, or hospitalization due to heart failure occurred in 65 patients and was independently predicted by shorter deceleration time, lower ratio of pulmonary vein systolic to diastolic velocity, and increasing levels of the ratios of early transmitral velocity to early annular velocity or velocity of propagation. For the ratio of early transmitral velocity to early annular velocity, this prediction was additive to deceleration time. Newer diastolic indexes provide an independent prediction of clinical outcomes.展开更多
文摘目的观察养心活血通脉汤对舒张性心衰患者(心气亏虚、痰瘀阻络证)左室舒张功能及N末端脑利钠肽原(N terminal pro B type natriuretic peptide, NT-proBNP)的影响。方法将65例患者随机分为治疗组33例与对照组32例,两组均以西医常规治疗,治疗组在此基础上加服养心活血通脉汤,治疗1个月后观察两组的临床疗效及治疗前后Lee心衰积分、中医证候积分、全血NT-proBNP、二尖瓣舒张早期血流峰值(EPFV)与二尖瓣舒张晚期血流峰值(APFV)之比值、二尖瓣环舒张早期运动峰速度(Ea)与二尖瓣环舒张晚期运动峰速度(Aa)之比值的变化。结果治疗组治疗后心衰疗效及中医证候疗效均优于对照组(P<0.05);治疗后两组Lee心衰积分和中医证候积分均较治疗前明显减少(P<0.01),且治疗组改善优于对照组(P<0.05);两组患者治疗后EPFV/APFV、Ea/Aa及NT-proBNP均较治疗前明显改善(P<0.01),且治疗组改善优于对照组(P<0.05)。结论养心活血通脉汤可提高舒张性心衰患者的临床疗效,改善左室舒张功能,其作用机制与降低NT-proBNP相关。
文摘Patients with diastolic heart failure(DHF) have significant abnormalities in left ventricular(LV) diastolic function, including slow and delayed relaxation and increased chamber stiffness. Whether and to what extent these abnormalities in diastolic function occur in association with abnormalities in LV systolic performance, function, and contractility has not been investigated thoroughly. Methods and Results-The systolic properties of the LV were examined in 75 patients with heart failure and a normal ejection fraction(ie, DHF) and 75 normal control subjects with no evidence of cardiovascular disease. LV systolic properties were assessed with echocardiographic and cardiac catheterization data. Stroke work(an index of LV systolic performance), preload recruitable stroke work and ejection fraction(indices of LV systolic function), systolic stress-shortening relationship, end-systolic pressure-volume relationship, and peak(+ )dP/dt(indices of LV contractility) were examined. The systolic properties of the LV were normal in patients with DHF. Stroke work was 8.4± 2.3 in DHF versus 8.8± 2.5 kg· cm in controls(P=0.26). Preload recruitable stroke work was 99± 22 in DHF versus 109± 18 g/cm2 in controls(P=0.13). The relationship between stroke work and end-diastolic volume was similar in DHF and controls. Peak(+ ) dP/dt was 1596± 362 in DHF versus 1664± 305 mm Hg/s in controls(P=0.54). The end-systolic pressure-volume relationship was increased in DHF. The systolic stress versus endocardial fractional shortening relationship was similar in DHF and controls. Conclusions-Patients with DHF had normal LV systolic performance, function, and contractility. The pathophysiology of DHF does not appear to be related to significant abnormalities in these systolic properties of the LV.
文摘The prognostic values of tissue Doppler imaging and color M-mode diastolic indexes were studied in 225 patients who had symptomatic systolic heart failure in the ADEPT study. The primary end point of death, transplantation, or hospitalization due to heart failure occurred in 65 patients and was independently predicted by shorter deceleration time, lower ratio of pulmonary vein systolic to diastolic velocity, and increasing levels of the ratios of early transmitral velocity to early annular velocity or velocity of propagation. For the ratio of early transmitral velocity to early annular velocity, this prediction was additive to deceleration time. Newer diastolic indexes provide an independent prediction of clinical outcomes.
